title: Aprotinin enhances the endogenous release of interleukin-10 after cardiac operations.
abstract: BACKGROUND
  Cardiopulmonary bypass (CPB) is characterized by the systemic release of proinflammatory cytokines, such as tumor necrosis factor-alpha and the interleukins 1 and 6, as well as endogenous antiinflammatory cytokines, including interleukin-10 (IL-10). Glucocorticoids reduce tumor necrosis factor-alpha plasma concentrations while enhancing IL-10 plasma concentrations after CPB. Aprotinin, a serine protease inhibitor used primarily to reduce blood loss after CPB, reduces CPB-induced proinflammatory cytokine tumor necrosis factor-alpha release similarly to glucocorticoids. This study evaluates the effect of full-dose aprotinin on the plasma concentrations of IL-10 after CPB.
  
  
  METHODS
  Twenty adults were randomized into a control (group C, n = 10) and a full-dose aprotinin-treated group (group A, n = 10). Plasma levels of IL-10 were measured by enzyme-linked immunosorbent assay technique at baseline (before anesthetic induction), and at 1 and 24 hours after CPB termination.
  
  
  RESULTS
  A significant (p < 0.05) increase of IL-10 occurred in both groups at 1 and 24 hours after termination of CPB when compared with the same group at baseline. In group A, the increase in IL-10 was significantly greater than in group C (p < 0.05) at 24 hours after CPB.
  
  
  CONCLUSIONS
  These results demonstrate an endogenous antiinflammatory response generated after CPB, characterized by IL-10 release, that is enhanced by aprotinin therapy. This study demonstrates a unique antiinflammatory activity of aprotinin that may be of clinical significance.
authors.affiliation: Department of Anesthesiology, University of Nebraska Medical Center, Omaha 68198-4455, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Hill
authors.forename: R P
authors.initials: RP
authors.lastname: Diego
authors.forename: A H
authors.initials: AH
authors.lastname: Stammers
authors.forename: S M
authors.initials: SM
authors.lastname: Huffman
authors.forename: R
authors.initials: R
authors.lastname: Pohorecki
mesh_terms: D007611:Aprotinin / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism*; D008875:Middle Aged; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology*
chemical_list: D015842:Serine Proteinase Inhibitors; D016753:Interleukin-10; D007611:Aprotinin